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SN Pathology final > CNS Pathoma > Flashcards

CNS Pathoma Flashcards

1
Q

Neural tube defects are associated with

A

Low folate levels prior to conception

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2
Q

How can neural tube defects can be detected?

A

Elevated AFP in amniotic fluid and maternal blood

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3
Q

If a failure to close happens at the cranial end we call it

A

Anencephaly

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4
Q

Anencephaly=

A

Absence of skull and brain

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5
Q

Anencephaly results in maternal ________

A

Polyhydramnios

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6
Q

Description of Anencephaly gross pathology

A

Frog like appearance

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7
Q

Failure of posterior vertebral arch to close is called

A

Spina bifida

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8
Q

Spina bifida leads to

A

Meningocele

Meningomyeleocele

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9
Q

Congenital stenosis of the channel that drains CSF from 3rd to 4th ventricle is called

A

Cerebral aqueduct stenosis

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10
Q

Cerebral aqueduct stenosis leads to

A

Accumulation of CSF in the ventricles

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11
Q

Cerebral aqueduct stenosis presents with

A

Enlarging head circumference

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12
Q

Congenital failure of the cerebellar vermis to develop is called

A

Dandy-Walker malformation

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13
Q

Dandy-Walker malformation presents with

A

Massively dilated 4th ventricle with absent of cerebellum

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14
Q

Congenital extension of cerebellar tonsils through foramen magnum

A

Arnold-Chiari malformation

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15
Q

CNS developmental anomalies list

A 
Anencephaly
Spina bifida
Cerebral aqueduct stenosis
Dnady-Walker malformation
Arnold-Chiari malformation type II
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16
Q

Spinal cord lesions list

A 
Syringomyelia
Poliomyelitis
Werding-Hoffman disease
Amyotrophic Lateral Sclerosis (ALS)
Friedreich Ataxia
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17
Q

Cystic degeneration of the spinal cord

A

Syringomyelia

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18
Q

Syringomyelia arises with

A

Trauma

Arnold-Chiari malformation

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19
Q

Syringomyelia presents with

A

Sensory loss of pain and temparture

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20
Q

Syringomyelia can cause _______ syndrome

A

Horner

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21
Q

Horner syndrome =

A

Ptosis
Miosis
Anhidrosis

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22
Q

Horner syndrome will happen due to

A

Disruption of the lateral horn of the hypothalamospinal tract

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23
Q

Poliovirus will cause

A

Poliomyelitis

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24
Q

Poliomyelitis =

A

Damage to anterior motor horn

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25
Q

Poliomyelitis presents with

A

Lower motor neuron signs

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26
Q

Main difference btw ALS and syringomyelia

ALS=

A

Syringomyelia will show lack of sensory impairment

Amyotropic Lateral Sclerosis

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27
Q

Most cases of ALS are ______

A

Sporadic

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28
Q

Familial cases of ALS will have

A

Zinc-Copper superoxide dismutase mutation

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29
Q

Degenerative disorder of the cerebellum and spinal cord is called

A

Friedreich ataxia

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30
Q

Meningitis =

A

Inflammation of the leptomeningis

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31
Q

Leptomeningis=

A

Pia and Arachnoid

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32
Q

Meningitis is most commonly due to

A

Infectious agent

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33
Q

Neonate meningitis causes

A

GBS
E.Coli
L. Monosytogenes

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34
Q

Children meningitis causes

A

N. Meningitdis

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35
Q

Adults meningitis causes

A

Sterp. Pneumo

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36
Q

Most common viral cause of meningitis

A

Coxsackivirus

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37
Q

Meningitis presents as

A

Headache
Neck stiffness
Fever

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38
Q

Bacterial meningitis CSF features

A

Neutrophils

Low glucose

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39
Q

Viral meningitis CSF features

A

Lymphocytes

Normal glucose

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40
Q

Fungal meningitis CSF features

A

Lymphocytes

Normal glucose

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41
Q

Complications of meningitis are seen in _________ meningitis

A

Bacterial

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42
Q

What can be the cause of Global cerebral ischemia?

A

Low perfusion
Shock
Anemia
Repeated episodes of hypoglycemia

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43
Q

Regional ischemia that results in neurologic deficit for > 24h is called

A

Ischemia stroke

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44
Q

Regional ischemia that results in neurologic deficit for < 24h is called

A

Transient Ischemic Attack TIA

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45
Q

Subtypes of Ischemic stroke

A

Thrombotic
Embolic
Lacunar

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46
Q

Thrombotic stroke results in ______ infarct at the _______

A

Pale

At the periphery of the cortex

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47
Q

Embolic stroke results in a ______ infarct at the ________

A

Hemorrhagic

At the periphery of the cortex

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48
Q

Lacunar stroke involves which blood vessels

A

Small vessels of the brain

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49
Q

In Lacunar stroke, the small vessels of the brain go through ___________ change

A

Hyaline arteriolosclerosis

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50
Q

Lacunar stroke most commonly involves ______ vessels

A

Lenticulostriate

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51
Q

Ischemic stroke leads to _______ necrosis

A

Liquefactive

52
Q

Earliest change in ischemic stroke

A

Red neurons

53
Q

1 month post ischemic stroke gross pathology will look like

A

Fluid filled cystic space surrounded by gliosis

54
Q

Bleeding into the brain is called

A

Intracerebral hemorrhage

55
Q

Intracerebral hemorrhage is usually due to

A

Rupture of Charcot-Bouchard microaneurysms

56
Q

Most common site of intracerebral hemorrhage

A

Basal ganglia

57
Q

Bleeding into the subarachnoid space is called

A

Subarachnoid hemorrhage

58
Q

Subarachnoid hemorrhage presents as

A

Sudden headache with nuchal regidity

59
Q

LP of subarachnoid hemorrhage will show

A

Xanthochromia (Yellow hue due to bilirubin breakdown)

60
Q

Subarachnoid hemorrhage happens most frequently due to

A

Rupture of Berry aneurysm

61
Q

Most frequent location of Berry aneurysm

A

Anterior circle of Willis (Branch point of anterior communicating artery)

62
Q

Berry aneurysm is associated with what diseases

A

ADPKD

Marfan syndrome

63
Q

CT scan of Epidural hematoma

A

Lens shaped lesion

64
Q

Epidural hematoma usually happens due to

A

Fraction of the temporal bone with rupture of the middle meningeal artery

65
Q

Subdural hematoma is usually due to

A

Tearing of bridging veins between Dura and Arachnoid

66
Q

Types of brain herniation

A

Tonsillar
Subfalcine
Uncal

67
Q

Tonsillar herniation can cause

A

Compression of brain stem -> Cardiopulmonary arrest

68
Q

PNS myelination

A

Schwann sells

69
Q

CNS myelination

A

Oligodendrocytes

70
Q

Inherited mutations in enzymes necessary for production or maintenance of myelin

A

Leukodystrophies

71
Q

Multiple sclerosis is caused by

A

Autoimmune destruction of CNS myelin and oligodendrocytes

72
Q

Multiple sclerosis is associated with

A

HLA-DR2

73
Q

Clinical featured of Multiple Sclerosis

Optic nerve

A

Blurred vision in one eye

74
Q

Clinical featured of Multiple Sclerosis

Brainstem

A

Vertigo and scanning speech

75
Q

Diagnosis of MS

A

MRI shows plaques

LP shows increased lymphocytes

76
Q

Treatment of acute attack of MS

A

High dose steroids

IFN-B

77
Q

Progressive mpMultifocal Leuko-Encephalitis is due to

A

JC virus infection of oligodendrocytes

78
Q

Central demyelination of pons is called

A

Central pontine myelinolysis

79
Q

Central pontine myelinolysis classically presents as

A

Locked in syndrome

80
Q

Central pontine myelinolysis is due to

A

Rapid IV correction of hyponatremia

81
Q

CNS metastatic lesion usually presents as

A

Multiple, well circumscribed lesions

82
Q

3 most common cancer that like to metastasize to the brain

A

Lung
Breast
Kidney

83
Q

Most abundant glial cell

A

Astrocytes

84
Q

Astrocytes make up the

A

BBB

85
Q

CNS tumors in adults usually occurs ________ the tentorium

A

Above

86
Q

What is the most common malignant tumor in adult

CNS

A

Glioblastoma Multiforme

87
Q

Glioblastoma Multiforme is a tumor of

A

Astrocytes

88
Q

Special feature of Glioblastoma Multiforme

A

Crosses the corpus callosum (Butterfly lesion)

89
Q

Which tumor produces butterfly lesion

A

Glioblastoma Multiforme

90
Q

Histology of Glioblastoma Multiforme

A

A lot of necrosis

Endothelial cell proliferation

91
Q

Benign tumor of the Arachnoid cells

A

Meningioma

92
Q

What is the most common benign CNS tumor in adults

A

Meningioma

93
Q

Meningioma expresses ________ receptor

A

Estrogen

94
Q

Meningioma histology picture

A

Whorled pattern

Psammoma bodies

95
Q

Schwannoma involves especially which CN?

A

8th at the CPA (Cerebellar Pontine Angle)

96
Q

Schwanomma is __ positive

A

S100

97
Q

Bilateral Schwanomma is seen in

A

NF2

98
Q

Degeneration of cortex leads to

A

Dementia

99
Q

Degeneration of brainstem and basal ganglia leads to

A

Movement disorders

100
Q

Dementia=

A

Memory loss
Cognitive dysfunction
No loss of consciousness

101
Q

Early onset AD is seen in

A

Familial cases

Down syndrome

102
Q

Familial cases of AD

What mutation?

A

Presenilin 1 / 2

103
Q

Why Down syndrome patient are prone to AD?

A

Amyloid Precursor Protein is found on chr. 21

104
Q

__ allele of _____ is associated with increased risk of AD

A

E4

Apo.E

105
Q

___ is associated with decreased risk to AD

A

E2 allele of Apo.E

106
Q

Morphological changes in AD

A

Cerebral atrophy
Neuritic plaques
Neurofibrillary tangles
Loss of cholinergic neurons in the nucleus basalis of Meynert

107
Q

What are neuritic plaque?

A

Extracellular core compromised of AB amyloid with entangled neuritic processes

108
Q

What is neurofibrillary tangle?

A

Intracellular aggregates of fibers composed of hyperphosphorylated tau protein

109
Q

What is Tau protein

A

Microtubule associated protein

110
Q

Multifocal infarction and injury due to HTN/Atherosclerosis/Vasculitis can cause

A

Vascular dementia

111
Q

Pick disease is a degenerative disease of

A

Frontal and temporal cortex

112
Q

Pick disease is characterized by

A

Round aggregates of tau protein in neurons of the cortex

113
Q

Pick disease is characterized by what symptoms

A

Behavioral and language

114
Q

Parkinson disease=

A

Degenerative loss of Dopaminergic neurons in the substantia nigra of the basal ganglia

115
Q

Basal ganglia helps to regulate ________

A

Movement

116
Q

Clinical features of Parkinson disease (4)

A

TRAP

Tremor
Rigidity
Akinesia
Postural instability

117
Q

Histology of Parkinson disease

A

Loss of pigmented neurons in sustantia nigra

Round, eosinophilic inclusions of a-synuclein (Lewy body)

118
Q

______ is a common feature of late Parkinson

A

Dementia

119
Q

Describe Huntington disease

A

Degeneration of GABAergic neuron in the caudate nucleus of the basal ganglia

120
Q

What is the genetics background of Huntington

A

AD
Chr. 4
Expanded CAG repeats in the Huntington gene

121
Q

Further expansion of repeats during spermatogenesis leads to _________ in Huntington

A

Anticipation

122
Q

Rapid movements=

A

Chorea

123
Q

Degenerative disease due to prion protein=

A

Spongiform encephalopathy

124
Q

Prion protein is normally expressed in

A

CNS neurons in an a-helical configuration

125
Q

Spongiform encephalopathy arises with conversion to a

A

Beta pleated conformation of the prion protein

SN Pathology final (13 decks)

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